CMS Formulary

Displaying 120041-120050 of 1611142 results.
ID: 120041
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1298870
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120042
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120043
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198284
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120044
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197316
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120045
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120046
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120047
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120048
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120049
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120050
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866491
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0